Aetna offers HMO, HMO-POS, PPO, and D-SNP plans. However, not all of its Medicare Advantage plans may be available in every area.
Aetna offers many Medicare Advantage (Part C) plans that fit multiple budgets and healthcare needs. Not every plan is available in every state, county, or ZIP code.
When choosing an Aetna Medicare Advantage plan, it’s best to consider your individual healthcare needs, including whether you have any health conditions that require certain services or take specific prescription drugs.
Keep reading to learn about the different Medicare Advantage plans available through Aetna.
Medicare Advantage (Part C) plans cover at least as much as original Medicare (Part A and Part B) plans. They’re popular because they usually provide extras like dental, vision, and hearing coverage. Private insurers offer a few different types of Medicare Advantage plans, such as:
- Health Maintenance Organization (HMO) plans
- Preferred Provider Organization (PPO) plans
- Private Fee-for-Service (PFFS) plans
- Special Needs Plan (SNP)
- Medicare Savings Account (MSA)
Aetna offers the following:
Aetna HMO plans
With most of Aetna’s Health Maintenance Organization (HMO) plans, you must choose an in-network primary care physician (PCP). You’ll also have access to a specified network of doctors and hospitals, including specialists.
You may need a referral from your PCP to see a specialist. In the case of an emergency, you’ll be able to use an out-of-network doctor, ER, or hospital. All plans include worldwide ER and urgent care coverage.
Aetna HMO-POS plans
Aetna also offers HMO Point-of-Service (HMO-POS) plans, which are HMOs that include an out-of-network option. Plan members may access medical treatment outside their HMO network for specific treatments or under special circumstances. With an Aetna HMO-POS plan, you’ll typically pay more to see an out-of-network doctor.
Aetna HMO-POS plans also require you to choose a PCP. Some require specialist referrals from your PCP.
Aetna PPO plans
Aetna’s Preferred Provider Organization (PPO) plans let you use any doctor, in and out of network, provided that they accept Medicare and Aetna’s plan terms. Receiving care from an out-of-network provider typically costs more.
You’re not required to choose a PCP and don’t need referrals to see specialists.
Aetna D-SNPs
Dual Eligible Special Needs Plans (D-SNPs) are designed for people who are eligible for both Medicare and Medicaid. This is known as being “dual eligible.”
These plans offer the most comprehensive benefits for people with the highest need. Most of these plans include access to a personalized care team.
Aetna offers three stand-alone Medicare Part D prescription drug plans:
- SilverScript Smart Rx
- SilverScript Choice
- SilverScript Plus
Aetna’s Medicare Advantage plans also include prescription drug coverage and a mail-order prescription drug benefit. You also get an over-the-counter medication benefit that will provide free access to many products.
If you are currently shopping for Medicare Advantage or separate Part D plans, you can use the Find a Medicare Plan tool to view each available plan in your area. You can enter your medications to see which plans cover them and how much they will cost.
Aetna offers Medicare Advantage plans in 49 states. Medicare Advantage plans are not currently sold in Alaska.
Although coverage is widely available throughout the country, specific types of plans and coverage options may only be offered in certain areas. This means that if a relative in another state has an Aetna plan, the same plan might not be available to you.
Coverage under Aetna Medicare Advantage plans varies based on the plan you choose. However, Aetna’s plans may include:
- dental
- hearing
- vision
- gym membership through the SilverSneakers program
Some plans also offer:
- access to nonemergency medical transportation services
- meal delivery at home after a hospital stay
Each plan may offer different benefits. Read them carefully to ensure you get the coverage you would use the most.
The cost of Aetna Medicare Advantage plans can vary by the type of plan you choose. The area where you live may also affect which plans you can choose from.
The following are some of the costs you may see with Aetna’s Medicare Advantage plans in different areas of the country in 2024.
| City/plan | Monthly premium | Health deductible; drug deductible | Out-of-pocket max | PCP visit | Specialist visit |
|---|---|---|---|---|---|
| Reno, NV: Aetna Medicare Value Plan (HMO-POS) | $0 | $0; $0 | $3,400 in network | $0 | $25 |
| Bothell, WA: Aetna Medicare Preferred Plan (PPO) | $0 | $0; $150 | $6.900 in network; $10,00 in and out of network | $0 | $40 |
| Wichita, KS: Aetna Medicare Value Plus Plan (HMO) | $35 | $0; $250 | $5,500 in network | $0 | $20 |
| Miami, FL: Aetna Medicare Credit (HMO) | $0 | $0; $0 | $3,850 in network | $0 | $35 |
| Staten Island, NY: Aetna Medicare Elite Plan (PPO) | $0 | $1,000; $300 | $7,550 in network; $11,300 out of network | $0 | $35 |
It’s important to know that these costs don’t include your monthly Part B premium, which you’ll have to pay in addition to your Part C plan costs. In 2024, the Part B premium is $240.
By entering your ZIP code into Medicare’s plan finder tool, you can compare the various plans available in your area.
Aetna offers many Medicare Advantage (Part C) plan options, including:
- HMO
- HMO-POS
- PPO
- D-SNP
Plans vary by cost and offerings in different states, counties, or ZIP codes.
You must be eligible for Original Medicare to join a Medicare Part C plan.